Our Choice: Homebirth (with a trip to Hospital for life saving surgery)

For me, after taking patient’s recollections of birth stories for 15 years as part of my medical history taking, homebirthing was the only choice for me when it came time to birth my first child. My husband had a son to a previous marriage and sadly his first wife was diagnosed with terminal cancer 2.5 years after the birth, leaving him a single father to a 4 year old boy. His birth story was one that my husband did not want to see repeated with an induction that failed, with “everything being stuck up her and in her for the next 5 days trying to get baby out” until the Emergency Cesarian saved the day. Birth was followed by her milk not coming down (often linked to the drugs in her system), a severe tongue tie not released until 4 weeks of age (when baby had already been put on formula as he couldn’t latch), post natal blues, and a start to family life that is all too common.

Thankfully, the Eligible Midwife Scheme had started in Brisbane in January 2015 which allows women to choose a private midwife to educate and guide them through their pregnancy instead of engaging an Obstetrician. The Eligible Midwife can then birth her at home, in the birth centre (midwife driven, mostly drug-free centre usually attached to hospitals), or in the birth suites which is often reserved for more complex birthing. A private midwife and an Obstetrician cost about the same – around $4000 with about half recoupable through Medicare.

December 13th saw me go into labour right on my due date around 7am. I had been told that being my first birth contractions can start and stop several times, and if they stop go to bed and rest up. It could be the last sleep I get for some time. My contractions stopped at 11pm so I had a warm shower and went to bed. This lull must have been the transition between dilation and contractions because at 1:30am the contractions came on full ball with strong desires to push. Perfect time for the birthing pool which was comfortably set up in our dining/birthing room. After every single contraction for the next 7 hours my midwives checked baby’s heart rate with doppler and both I and baby were doing fine. After some guided pushing towards my tailbone, baby was out within 20 minutes. Yes, you can push the wrong way! If I was in a hospital, I would have required a Cesarian as their time guidelines for the second stage of labour is shorter than what my body required (by a long shot).

My daughter was born and bobbed her head straight to my breast and latched on. She suckled for a good hour while we waited for the placenta to give way, but it didn’t. Suckling can make the placenta detach but when it doesn’t new mothers can continue to bleed. Baby was cut off the cold white umbilical cord and put onto Daddy’s bare chest so I could receive an injection, and then 20 minutes later I received another injection, neither of which worked in expelling my placenta. This happens in up to 3% of births in Australia. Within the next 20 minutes, the ambulance had arrived, loaded me and Bub onto the stretcher and wheeled me in to theatre for a manual removal of the placenta. Without this surgery, I would have bled to death. The doctors and nurses in the Royal Brisbane Women’s Hospital were fantastic, except for the horrible female Anaesthetist who was nothing but insulting of my choice to birth at home. Other than her, the team in at RBWH was brilliant, efficient and were supportive during our stay there for the next four days, with my daughter staying with me as a boarder. I had lost so much blood, I couldn’t walk more than a few steps over the next 2 weeks without dropping to my knees. My haemoglobin had dropped from 147 before the birth to 67. I had lost close to half my blood.

I feel that the greatest gift I have given my daughter was an uninterrupted birth. She experienced the whole cocktail of my hormones through the whole birthing process without any drugs in my system or hers. The second greatest gift I’ve given her is 2 years of breastfeeding, which would not have been possible without the $800+ lip and tongue tie release (frenectomy) performed at 7 days of age. WHO recommends breastfeeding for a minimum of two years, but unfortunately our society isn’t supporting mothers enough to enable this here in Australia. The delays, or lack of recognition, in tongue/lip tie diagnosis causes mothers to dry up, or experience painful nipple and breast trauma making life harder than necessary for a new under slept mum. For both mother and child, breastfeeding is their medicine as it’s protective for both – for the child in their development of their immune system, protection from illness, and establishment of their microbiome, while for mothers nursing can protect against some cancers, assist in better quality sleep (when you do get some) and can aid in bonding.

So, would I homebirth again for baby number 2? I would love to. However what makes that easier to say is that I live close – within 3 km – of the hospital. This way, the intervention is nearby should it be required but hospital policies are not causing unnecessary intervention while my body is happily birthing the way it should. The last thing a birthing woman should be worried about is beating the clock… if her body doesn’t birth fast enough, the state guidelines direct doctors to intervene.

My most likely option for baby #2 would be to engage an Eligible Midwife again and labour in the birthing suites at the hospital. This way, my midwife stands between me and the hospital policies, so if my cervix is not dilating at 1/2cm per hour, I do not automatically get induced to speed things up. And if I need to push for more than 2 hours to safely deliver my baby, I don’t have the automatic threat of a scalpel ready to cut my baby out. And if we want to wait for baby to get all of it’s blood (and all of its iron) from the placenta before clamping and cutting the cord, then my midwife will be sure to help that happen. This way, it gives my baby that little bit more strength to tackle life from Day 1.